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BALI MEDICAL JOURNAL (BMJ)
Published by Universitas Udayana
ISSN : -     EISSN : -     DOI : -
Core Subject : Health,
Medicine & Pharmacology
Bali Medical Journal (BMJ), P-ISSN 2089-1180, E-ISSN 2302-2914 is an international and peer-reviewed journal published quarterly in print and online by Sanglah General Hospital in collaboration to Indonesian Physician Forum and Indonesian College of Surgeon, Bali-Indonesia which was founded in 2011. The Journal aims to bridge and integrate the intellectual, methodological, and substantive diversity of medical scholarship, and to encourage a vigorous dialogue between medical scholars and practitioners. The Journal welcomes contributions which promote the exchange of ideas and rational discourse between practicing educators and medical researchers all over the world.
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Articles 29 Documents
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Search results for , issue "Vol 5 No 2 (2016)" : 29 Documents clear
The Relationship Between Education, Job, and Family Income with TB Medication Dropouts in Timor-Leste Silva, Valente Da; Suryadhi, Tigeh; N., Wirawan; Bakta, ade
BALI MEDICAL JOURNAL Vol 5 No 2 (2016)
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Abstract

Background: TB treatment dropout is one causes of treatment failure, which could increase drug resistant cases. Drug resistant cases of TB were reported by the Ministry of Health of East Timor in 2008 (3 cases), 2009 (3 cases), and in 2010 (6 cases). With drug resistant emerging, TB will require longer treatment time. According to the WHO report (2013) the results of pulmonary tuberculosis BTA (+) treatment were reported: Year 2010 the number of failure of treatment was (0.53%); Died of TB (3.53%); Drop out of treatment (4.05%); Outmigration (3.98%); In 2011 cases of treatment failure (0.50%) Died of TB (3.36%); Drop out of treatment (3.36%); Outmigration (1.92%); In 2012 cases of treatment failure (1.03%); Died of TB (3.49%) Drop out of treatment (4.59%) and migration, (2.26%). According to the National Statistics Directorate (NSD) in 2011, that the East Timorese people still live mostly 70.4% in the rural areas. While access to health services remains a challenge, since the people of Timor Leste proclaimed the restoration of its independence. Objective: This study aimed to determine whether there is a relationship between the variables of education, family income, and job with cases of TB medication discontinuation. Methods: This study was conducted using descriptive correlation method. The sample was determined by Ridwan & Akdon (2010) formula. The total of samples was 100 people who met the inclusion and exclusion criteria, and selected randomly. This research was conducted in District Manatuto and Liquica Timor-Leste on March 28, 2015. Results: The correlation test showed a strong positive relationship level if r = 0.51 until +1. Analysis of significance value of r xy = 0.671 and p = 0.000 indicates that there is a significant relationship between the variables of education, job and income with variable discontinuation of treatment. Conclusion: Based on the results of research and data analysis, it can be concluded that the results of this study are as follows: There was a significant relationship between the variables of education, household income, and jobs to the discontinuation of TB treatment.
Treatment of a Recurrent Vaginal Obstruction With a Modified Mold After an Excision of a Transverse Vaginal Septum Megadhana, I Wayan
BALI MEDICAL JOURNAL Vol 5 No 2 (2016)
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Abstract

Background: A vaginal obstruction often occurs as a complication in women who had previously undergone an excision of a transverse vaginal septum. The use of a mold coated with membranes in the correction surgery provides a good healing prognosis. Objective: To report a case of a treatment of a recurrent vaginal obstruction with a modified mold after undergoing an excision of a transverse vaginal septum in a 15-year-old woman. Result: A follow-up on the patient, four months after using the modified mold, showed a regular menstrual cycles without a sign of vaginal narrowing, an infection, nor a complaint. Conclusion: The treatment using a modified mold, for a recurrent vaginal obstruction after an excision of a transverse vaginal septum, is a new innovation with a satisfactory result.
Older Age and Worse Nutritional State Were Related with Impaired Inflammatory Response in Elderly Patients Kuswardhani, Tuty; Sukrawan, Gede; Suastika, Ketut
BALI MEDICAL JOURNAL Vol 5 No 2 (2016)
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Abstract

Background: Ageing process is related with multisystem disorders. One of them is immune response impairment. It is imperative to evaluate the association between age and related nutritional status with inflammatory response in elderly patient. Methods: A cross sectional study to evaluate inflammatory response among elderly patients (?60 years) at Geriatric Out -patient Clinic, Sanglah Hospital was conducted. Seventy-two patients were enrolled in the study. Age, nutritional states (body mass index and mini nutritional assessment), and inflammatory markers (interleukin-2 [IL-2] and C-reactive protein [CRP]) and other anthropometric as well as laboratory parameters were measured in the study. Results: In the study it was revealed that age has a moderately negative correlation with both of plasma IL-2 and serum CRP levels (R= -0.305, p=0.009; and R= -0.413, p=0.005, respectively). Plasma IL-2 levels were positively correlated with several variables like body mass index (R=0.282, p=0.016), mini nutritional assessment (R=0.237, p=0.045), biceps skin fold (R=0.291, p=0.013), and triceps skin fold (R=0.258, p=0.028). While serum CRP levels has positive correlation with lying diastolic blood pressure (R=0.345, p=0.020) and negative correlation with calf circumference (R=-0.312, p=0.037). No significant associations were found between diabetes and hypertension with inflammatory markers. Conclusion: This study concluded that older age and worse nutritional state were related to worse inflammatory response in the elderly patients.
Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio as Novel Markers for Diagnosis of Sudden Sensorineural Hearing Loss: A Systematic Review and Meta-analysis Bahrami, Mohammad Amin; Ansari, Abdollah; Ara, Kefayat Chaman; Bahrami, Elham; Bahrami, Sima; Bahrami, Mohammad Nabi; Barati, Omid; Moosazadeh, Mahmood; Kum, Rauf O?guzhan
BALI MEDICAL JOURNAL Vol 5 No 2 (2016)
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Abstract

Background: Sudden sensorineural hearing loss (SSNHL) is a common otologic disease characterized by a loss of hearing greater than 30 dB in three consecutive frequencies which occurs in less than 72 hours. Objective: To investigate the role of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) on sudden sensorineural hearing loss (SSNHL). Search strategy: A PubMed, Science Direct, Scopus, OVID, EMBASE and Google Scholar search (date last searched April 2016) without any time, language and location restriction was done. Inclusion criteria: All case-control studies, which have been investigated the relationship of NLR and PLR with the occurrence of SSNHL were included in our meta-analysis. Results: A total of 5 case-control studies were included in the study. All 5 studies have been reported NLR of patients and control groups (611 patients and 804 controls). Our analysis showed that the mean NLR of patients is 1.12 (0.82-1.43) unit higher than that of controls with 95% CI which is statistically significant. Also, 3 studies have been reported PLR of patients and control groups (512 patients and 705 controls). Our analysis showed that the mean PLR of patients is 0.57 (0.08-1.05) unit higher than that of controls with 95% CI which is statistically significant too. Conclusions: This metaanalysis confirmed the relationship of NLR and PLR with SSNHL. Therefore, these parameters can be considered as new markers in diagnosis of SSNHL.
Evaluation and Prioritization of Service Quality Dimensions Using Dematel and Topsis (A Case Study in Iran) Khanjankhani, Khatere; Rafiei, Sima; Ezzatabadi, Mohammad Ranjbar; Askari, Roohollah; Abooee, Fatemeh; Shafii, Milad
BALI MEDICAL JOURNAL Vol 5 No 2 (2016)
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Abstract

Background: Hospital services quality plays an increasingly important role in today’s competitive environment. This study aimed to evaluate causal effects of different healthcare quality aspects on quality of services perceived by patients in hospitals affiliated by Shahid Sadoughi University of Medical Sciences using DEMATEL and TOPSIS techniques in 2014. Method: Through literature review and expert opinions, different service quality dimensions in under study hospitals were identified and required data were gathered. In the next step, DEMATEL technique was applied to determine cause and effect relationships between identified quality aspects and quality perceived by service recipients. Also to rank dimensions according to their priorities, TOPSIS method was used. Given the literature review, six quality dimensions including responsiveness, assurance, security, tangibility, communication and patient centeredness were identified. Result: Results obtained from DEMATEL technique introduced patient security as an influential aspect which was ranked in the sixth place in terms of importance. Conclusion: The prioritization of quality dimensions along with their causal effects provides a beneficial insight for hospital managers to effectively plan and make improvement decisions. It is suggested that considering a remarkable impact of security on patients’ perception toward quality of care, this aspect should be regarded in decision makers’ programs with a greater emphasis.
Betel Leaf Extract (Piper betle L.) Antihyperuricemia Effect Decreases Oxidative Stress by Reducing the Level of MDA and Increase Blood SOD Levels of Hyperuricemia Wistar Rats (Rattus norvegicus) Sumarya, I M.; Adiputra, N.; Sukrama, I D. M.; Manuaba, Ida Bagus Putra
BALI MEDICAL JOURNAL Vol 5 No 2 (2016)
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Abstract

Background: Betel leaf extracts (Piper betle L.) antioxidant activity and enzyme inhibitors of XO. Hyperuricemia cause oxidative stress by increasing the formation of reactive oxygen species (ROS) cause lipid peroxidation and oxygenation of low-density lipoprotein cholesterol (LDLc). Objective: The aim of this research was to determine the betel leaf extract as an anti hyperuricemia that can lower the blood uric acid levels and oxidative stress by lowering the levels of MDA and increase the SOD of hyperuricemia of the rat’s blood. Method: Experimental research was conducted with the design of The Randomized Post Test Only Control Group Design, on normal Wistar rats (Rattus norvegicus), administered with oxonic potassium (hyperuricemia) and the hyperuricemia rats either given betel leaf extract and allopurinol. After the experiment of uric acid levels, MDA and SOD in rat blood determined. Results: The results showed that the betel leaf extract significantly (p <0.05) lower uric acid levels, MDA and increase levels of SOD in rat blood. There is a positive correlation between the levels of uric acid with MDA levels and a negative correlation, although not significantly with SOD (p >0.05). Conclusion: It can be concluded that the betel leaf extract as an anti-hyperuricemia can lower the uric acid levels and decreases oxidative stress by lowering the levels of MDA and increasing the SOD.
Relative Humidity of 40% Inhibiting the Increase of Pulse Rate, Body Temperature, and Blood Lactic Acid During Exercise Sandi, N.; Adiputra, N.; Pangkahila, A.; Adiatmika, P. G.
BALI MEDICAL JOURNAL Vol 5 No 2 (2016)
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Background: Excessive sweating of the body is a reaction to decrease the heat caused by prolonged exercise at high relative humidity (RH). This situation may cause an increase in pulse rate (PR), body temperature (BT), and blood lactic acid (BLA) workout. Objective: This study aimed to prove that a RH of 40% better than a RH of 50% and 60% RH in inhibiting the increase of PR, BT, and BLA during exercise. Methods: The study was conducted on 54 samples randomly selected from the IKIP PGRI Bali students. The samples were divided into three groups, and each group was given cycling exercise with a load of 80 Watt for 2 x 30 minutes with rest between sets for five minutes. Group-1 of cycling at 40% of RH, Group-2 at a RH of 50%, and the Group-3 at a RH of 60%. Data PR, BT, and BLA taken before and during exercise. The mean difference between groups before and during exercise were analyzed by One-way Anova and a further test used Least Significant Difference (LSD). Significance used was ? = 0.05. Results: The mean of PR during exercise was significantly different between groups with p = 0.045, the mean of BT during exercises was significantly different between groups with p = 0.006, and the mean of BLA during exercises was significantly different between groups with p = 0.005 (p
Association of Epidermal Growth Factor Receptor (EGFR) with Tumor Location and Clinicopathological Aspect in Head and Neck Squamous Cell Carcinoma Nuratna, I Nyoman Diwiya Abdi; Wisesa, Ida Bagus Made Surya
BALI MEDICAL JOURNAL Vol 5 No 2 (2016)
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Abstract

Background: Head and neck squamous cell carcinoma (HNSCC) is the most common type of head and neck cancer. Most patients came with advanced disease which results in suboptimal treatment. EGFR is one of prognostic factors that play important role in HNSCC pathogenesis and progression. Unraveling the expression profile of EGFR in anterior and posterior HNSCC and its comparison would provide physician with better information regarding EGFR based treatment or its prognostic value. Methods: An observational cross sectional analytic study was conducted to compare EGFR expression between anterior and posterior HNSCC. The association between EGFR expressions with clinicopathological aspects (tumor stadium and histological grade) of HNSCC which analyzed separately. Baseline characteristic and each variable were first analyzed descriptively. Comparative analysis was conducted using Chi-Square and Fisher exact test with p value less than 0.05 was considered significant. Result: 48 samples were used in this study. Most of the subjects were elderly (83.2%), men (72.9%) and came with advanced disease (Clinical Stadium III-IV) (83.3%). Most of the subjects were EGFR (+) (93%). In anterior region group, low expression of EGFR was found in 6 patients (25%) and high expression in 18 patients (75%). Meanwhile in posterior region group we found low expression in 10 patients (41.7%) and 14 patients with high expression of EGFR (58.3%). We found no association between EFGR and HNSCC location (anterior or posterior) (p=0.221). Insignificant association also reported between EGFR expression with clinical stage of anterior (p=0.625) and posterior (p=0.283) HNSCC as well as histopathological grade of both location (p=0.33 for anterior group and p=0.371 for posterior group). Conclusion: We concluded that EGFR was diffusely expressed in HNSCC but there was no association between EGFR expression and clinicopathological characteristics and location of HNSCC.
Correlation Between Protein Intake and Nitrogen Balance of Surgical Patients in Anesthesiology and Intensive Care Installation, Sanglah General Hospital, Denpasar, Bali, Indonesia Wiryana, Made; Sinardja, I Ketut; Senapathi, Tjokorda Gde Agung; Widnyana, I Made Gede; Panji, Putu Agus Surya; Aryabiantara, I Wayan; Cindryani, Marilaeta
BALI MEDICAL JOURNAL Vol 5 No 2 (2016)
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Abstract

Background: A cell injury from surgical stress in a trauma or a non-trauma case will induce a hyper metabolic response in which the protein degradation increases, the somatic protein synthesis decreases and the amino acid catabolism increases. Thus, the pyper metabolic response contributes to nitrogen loss in urine. This response, without an adequate nutrition, will lead an iatrogenic malnutrition and deterioration. A balance nitrogen formula through urinary urea nitrogen is one of many nutrition evaluation methods. This method aids in evaluating the daily nutrition status and it can be the baseline data for daily intake. Objective: To find a correlation between the protein intake and the nitrogen balance of the surgical patients in anesthesiology and intensive care installation, Sanglah General Hospital, Denpasar, Bali. Methods: Fifty-one surgical patients with trauma and non-trauma cases were observed for their protein intake for 2-3 days continuously. Moreover, they were evaluated for their nitrogen balance based on the urinary urea nitrogen per 24 hours for 2-3 days. For statistical analysis, we utilized Shapiro-Francia, Shapiro-Wilk, Spearman Frank correlation, two-sample t test, and multivariate regression analysis in Strata SE 12.1. Results: The correlation between the protein intake and the nitrogen balance on the first day was ra=0.50 (p<0.05), on the second day ra=0.70 (p<0,05), and on the third day ra=0.740 (p<0,05) Conclusions: There is a correlation between the protein intake and the nitrogen balance of surgical patients in Anesthesiology and Intensive Care Installation Sanglah General Hospital Denpasar.
Correlation between Nerve Growth Factor (NGF) with Brain Derived Neurotropic Factor (BDNF) in Ischemic Stroke Patient Widodo, Joko; Asadul, Andi; Wijaya, Andi; Lawrence, Gatot
BALI MEDICAL JOURNAL Vol 5 No 2 (2016)
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Abstract

Background: The neurotrophins nerve growth factor (NGF) and brain derived neurotrophic factor (BDNF) is a family of polypeptides that play critical role during neuronal development, appear to mediate protective role on neurorepair in ischemic stroke. Naturally in adult brain neurorepair process consist of: angiogenesis, neurogenesis, and neuronal plasticity, it can also be stimulated by endogenous neurorepair. In this study we observed correlation between NGF and BDNF ischemic stroke patient’s onset: 7-30 and over 30 days. Methods: This is cross sectional study on 46 subjects aged 38 – 74 years old with ischemic stroke from The Indonesian Central Hospital of Army Gatot Subroto Jakarta. Diagnosis of ischemic stroke was made using clinical examination and magnetic resonance imaging (MRI) by neurologist. Subjects were divided into 2 groups based on stroke onset: 7 – 30 days (Group A: 19 subjects) and > 30 days (Group B: 27 Subjects). Serum NGF levels were measured with ELISA method and BDNF levels were measured using multiplex method with Luminex Magpix. Results: Levels of NGF and BDNF were significantly different between onset group A and B (NGF p= 0.022, and BDNF p=0.008), with mean levels NGF in group A higher than group B, indicating that BDNF levels is lower in group A than group B. There was no significant correlation between NGF and BDNF levels in all groups. Conclusion: The variations in neurotrophic factor levels reflect an endogenous attempt at neuroprotection against biochemical and molecular changes after ischemic stroke. NGF represents an early marker of brain injury while BDNF recovery is most prominent during the first 14 days after onsite but continuous for more than 30 days. There is no significant correlation between NGF and BDNF in each group.

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